A short or tense muscle is identified by internal examination and then released centrally along the bulk of the muscle or at the attachment to bone which is often more uncomfortable.
A trigger point will often refer pain elsewhere in the pelvic floor or to the hips or rectum or may just be painful on the spot. Once held for a few seconds the pain eases and the therapist moves on to the next point.
There are also nerves in the pelvic floor and they can be mobilised along their pathways.
Manual therapy should not be so painful that the patient reacts by tensing up. The pelvic floor muscles should NOT be sore after manual therapy.